Thursday, May 21, 2015

Gov. Scott's health care funding panel sparring with hospitals

TALLAHASSEE — A commission that Gov. Rick Scott created this month is facing off with hospitals as it looks for ways to make government spending on health care more efficient.

But after the first meeting of the Commission on Healthcare and Hospital Funding on Wednesday, it's clear that solutions won't come until after the June 30 deadline for the Legislature to pass a budget, including on health spending. There's a lot of information for the panel to collect and analyze, chairman Carlos Beruff said.

"I don't think you'll have all the data by the end of special session," Beruff said, referring to the June 1-20 window lawmakers gave themselves to approve the budget. "It'd be interesting to try."

The commission's nine members aren't necessarily tasked with solving the current stalemate over federal funding for Medicaid and the Low Income Pool that expires June 30. Still, their early conversations have centered on those programs and the financial records of hospitals that are reimbursed by government for treating low-income patients.

"Floridians should have the best health care access that the state's willing to pay for," said Jason Rosenburg, the only medical doctor on the commission. "I don't know as a citizen and as a physician what we're paying for, and I don't think the rest of the state does."

Many hospitals have fought back against deep dives into their finances by the commission or Scott, himself a former hospital CEO. Dozens refused to provide financial information, including profits and top executives' salaries, referring instead to records filed each year with the state and federal government.

"Florida Hospital regularly reports financial and hospital utilization data to the Agency for Health Care Administration, as required by state law," wrote Brian Adams, president and chief executive officer of Florida Hospital Tampa, in a letter. "We believe our submissions are up to date, accurate and readily available to the public for review. In order to meet your urgent request, we respectfully refer you to consult AHCA to obtain this comprehensive information."

On Wednesday, commissioners bit back.

"If they receive tax dollars, they should be responsible for giving us the information that would help us make sure that the tax dollars are being spent wisely," commissioner and former Destin Mayor Sam Seevers said.

Another member of the commission, lawyer Marili Cancio Johnson, said she wants to know which hospitals didn't respond with comprehensive answers to the voluntary survey, as well as how much state money each receives.

The hospitals' standoff with the commission stems in part from Scott's suggestion that the bills for those who cannot afford insurance should be footed by the hospitals themselves through profit sharing. In a letter to the governor on Monday, the Florida Hospital Association called such a plan an extra tax on the industry and said it "is not a solution to the challenge we face."

Instead, hospitals advocate expanding Medicaid, a proposal Scott adamantly opposes.

In the fervor of the disagreements between hospitals and the governor and commission, some people say those responsible for setting health policy have lost sight of the bigger picture.

"The one thing you are missing is the patients," said Tom Brooks, the only member of the public to speak at Wednesday's hearing. "It's the 800,000 people in this state that are uninsured."

Brooks drove 4 1/2 hours to Tallahassee from DeLand so he could speak to the commissioners. He said they should focus less on the number of dollars being spent on health care and more on getting more people insured so they can afford preventive medicine.

"If you want patient-centered outcomes, then you have to get people health insurance," Brooks said. "Where's the discussion today about these people?"

Contact Michael Auslen at mauslen@tampabay.com

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